Comparative efficacy of non-ablative radiofrequency and promestriene in management of the genitourinary syndrome and sexual dysfunction in cervical cancer survivors: a pilot randomized trial

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BACKGROUND: Radiotherapy for cervical cancer can lead to genitourinary syndrome (GUS), which negatively impacts sexual function and the quality of life among female cancer survivors. OBJECTIVE: To evaluate the efficacy of promestriene and non-ablative radiofrequency (NARF) in treating GUS and its effects on sexual function in women who have undergone radiotherapy for cervical cancer (CC). METHOD: In this pilot randomized clinical trial included 24 women who had received radiotherapy and/or brachytherapy for CC within the past five years. Participants were randomized to receive treatment with promestriene cream or intravaginal (NARF). Sexual function was assessed pre- and post-treatment using the Female Sexual Function Index (FSFI). Vaginal symptoms were evaluated using a visual analog scale (VAS), and histological analyses of vaginal biopsies were performed before and after the intervention. OUTCOMES: The main outcomes measured were improvements in sexual function and reductions in vaginal symptoms. RESULTS: Significant improvements in FSFI scores and reductions in vaginal symptom intensity were observed in both treatment groups. The median FSFI score increased from 13.0 to 23.1 after treatment. Histological analysis demonstrated a significant increase in epithelial thickness and an improvement in stromal quality in both groups. No significant differences were noted between the promestriene and (NARF) groups concerning sexual function improvements or symptom reduction. CLINICAL IMPLICATIONS: Both promestriene and (NARF) proved effective and safe enhancing sexual function and reducing vaginal symptoms in post-radiotherapy CC survivors. STRENGTHS AND LIMITATIONS: The study's strengths include its randomized design and comprehensive assessment of subjective and objective outcomes. However, the small sample size and limited follow-up period limit the generalization and long-term applicability of the findings. CONCLUSION: Both promestriene and (NARF) significantly improve sexual function and alleviate vaginal symptoms in women treated with radiotherapy for CC, presenting viable options for managing GUS in this patient population.

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